Healthcare Provider Details

I. General information

NPI: 1528986908
Provider Name (Legal Business Name): NYA SIMMONS LPC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 ATRIUM WAY STE 118
COLUMBIA SC
29223-6382
US

IV. Provider business mailing address

1016 E MACREE TER
FLORENCE SC
29505-7221
US

V. Phone/Fax

Practice location:
  • Phone: 800-915-8615
  • Fax: 800-915-8615
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number11049
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: